AccountId: 011433970860
ContactId: a1277cb7-3e4e-4f0f-8f7e-f1c57b6f3c8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238419 ms
Total Talk Time (AGENT): 88890 ms
Total Talk Time (CUSTOMER): 92701 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/a1277cb7-3e4e-4f0f-8f7e-f1c57b6f3c8a_20250303T17:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, I'm calling for claim status.
[AGENT][NEUTRAL] Sure, I can check in a claim for you. uh, what was your name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] [PII], are you, uh, the insured or are you with a provider's office?
[CUSTOMER][NEUTRAL] I'm with the provider's office.
[AGENT][NEUTRAL] OK, and then can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] 1462918
[AGENT][NEUTRAL] Alright, and then what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII] uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] This is um [PII].
[AGENT][NEUTRAL] OK, and then do you have the bill amount?
[CUSTOMER][NEUTRAL] It is um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The 310.
[AGENT][NEUTRAL] You can. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, [PII], what was the name of the provider's office you're with?
[CUSTOMER][POSITIVE] It's uh balanced women's health.
[AGENT][NEUTRAL] OK, so I do have a claim for that date of service, um, however, it's for $360.
[CUSTOMER][NEUTRAL] 360.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I was looking at the wrong, um, yeah, it's [PII] and then [PII], yeah, I was looking at the wrong one.
[AGENT][NEUTRAL] Yes, yes. OK, got it. Just wanted to make sure we're looking at the right one. OK, so we did receive the claim, uh, we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Office visit it's not covered.
[CUSTOMER][NEUTRAL] OK. And um
[CUSTOMER][NEUTRAL] Would you be able to
[CUSTOMER][NEUTRAL] Um, fax over the explanation of benefits.
[AGENT][POSITIVE] Of course, absolutely. What was that fax number for you?
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] 888
[CUSTOMER][NEUTRAL] 967 9.
[AGENT][NEUTRAL] OK, I'm gonna read that back, make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and I would just put this to your attention?
[CUSTOMER][NEUTRAL] Oh, and also, um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I do have, I, I do have a question about this because I just noticed because you said it said office visits aren't covered, but does that mean like because it's not, it was through telehealth.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right, um, so this policy doesn't offer that sort of coverage anyway, so that's still what it would be considered.
[CUSTOMER][POSITIVE] OK. So, OK. All right. Thank you so much for your help. Um, oh, can I get a
[AGENT][POSITIVE] Yeah, you're very welcome.
[CUSTOMER][NEUTRAL] Reference number for the call?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Last initial is [PII] And was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Uh, no, that'll be it. Thank you so much for your help.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.